TY - BOOK AU - Lhermusier, Thibault AU - Waksman, Ron TI - Prasugrel hydrochloride for the treatment of acute coronary syndromes. [Review] SN - 1465-6566 KW - *Acute Coronary Syndrome/dt [Drug Therapy] KW - *Piperazines/tu [Therapeutic Use] KW - *Platelet Aggregation Inhibitors/tu [Therapeutic Use] KW - *Purinergic P2Y Receptor Antagonists/tu [Therapeutic Use] KW - *Thiophenes/tu [Therapeutic Use] KW - Animals KW - Aspirin/tu [Therapeutic Use] KW - Clinical Trials, Phase III as Topic KW - Drug Therapy, Combination KW - Humans KW - Percutaneous Coronary Intervention KW - Piperazines/pd [Pharmacology] KW - Piperazines/pk [Pharmacokinetics] KW - Platelet Aggregation Inhibitors/pd [Pharmacology] KW - Platelet Aggregation Inhibitors/pk [Pharmacokinetics] KW - Practice Guidelines as Topic KW - Purinergic P2Y Receptor Antagonists/pd [Pharmacology] KW - Purinergic P2Y Receptor Antagonists/pk [Pharmacokinetics] KW - Randomized Controlled Trials as Topic KW - Thiophenes/pd [Pharmacology] KW - Thiophenes/pk [Pharmacokinetics] KW - Ticlopidine/aa [Analogs & Derivatives] KW - Ticlopidine/tu [Therapeutic Use] KW - MedStar Heart & Vascular Institute KW - Journal Article KW - Review N2 - AREAS COVERED: This review describes prasugrel chemistry, pharmacokinetics, pharmacodynamics and clinical studies. In a Phase III randomized clopidogrel-controlled trial, prasugrel improved cardiovascular outcome (risk reduction of cardiovascular death, non-fatal heart attack and non-fatal stroke) at the cost of increased major and fatal bleeding complications. Prasugrel, in combination with aspirin, has been approved by European and American regulatory agencies for the prevention of atherothrombotic events in patients with ACS who undergo percutaneous coronary intervention (PCI); EXPERT OPINION: Prasugrel is effective for managing ACS patients with planned PCI and it offers an alternative with potential benefits over clopidogrel. Prasugrel is currently challenged by ticagrelor, a P2Y12 receptor antagonist with different pharmacokinetic/pharmacodynamic properties. The superiority of one drug to the other cannot be reliably estimated from the current trials. Ongoing randomized and observational studies may help to provide valuable information on the safety and efficacy of these two drugs and their respective places with ACS patients; INTRODUCTION: P2Y12 receptor antagonists, by inhibiting platelet activation and subsequent aggregation, are critical to prevent ischemic event recurrence after an acute coronary syndrome (ACS). Prasugrel is a third-generation thienopyridine whose metabolites target the P2Y12 receptor. Compared with clopidogrel, prasugrel has a more potent, faster in onset, and more consistent P2Y12 receptor inhibition UR - http://dx.doi.org/10.1517/14656566.2015.1005602 ER -